title: Influence of acute complications on outcome 3 months after ischemic stroke.
abstract: BACKGROUND
  Early medical complications are potentially modifiable factors influencing in-hospital outcome. We investigated the influence of acute complications on mortality and poor outcome 3 months after ischemic stroke.
  
  
  METHODS
  Data were obtained from patients admitted to one of 13 stroke units of the Berlin Stroke Registry (BSR) who participated in a 3-months-follow up between June 2010 and September 2012. We examined the influence of the cumulative number of early in-hospital complications on mortality and poor outcome (death, disability or institutionalization) 3 months after stroke using multivariable logistic regression analyses and calculated attributable fractions to determine the impact of early complications on mortality and poor outcome.
  
  
  RESULTS
  A total of 2349 ischemic stroke patients alive at discharge from acute care were included in the analysis. Older age, stroke severity, pre-stroke dependency and early complications were independent predictors of mortality 3 months after stroke. Poor outcome was independently associated with older age, stroke severity, pre-stroke dependency, previous stroke and early complications. More than 60% of deaths and poor outcomes were attributed to age, pre-stroke dependency and stroke severity and in-hospital complications contributed to 12.3% of deaths and 9.1% of poor outcomes 3 months after stroke.
  
  
  CONCLUSIONS
  The majority of deaths and poor outcomes after stroke were attributed to non-modifiable factors. However, early in-hospital complications significantly affect outcome in patients who survived the acute phase after stroke, underlining the need to improve prevention and treatment of complications in hospital.
authors.affiliation: Center for Stroke Research Berlin (CSB), Klinik für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Division of Health and Social Care Research, King's College London, London, United Kingdom.
authors.forename: Maike Miriam
authors.initials: MM
authors.lastname: Grube
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Koennecke
authors.forename: Georg
authors.initials: G
authors.lastname: Walter
authors.forename: Andreas
authors.initials: A
authors.lastname: Meisel
authors.forename: Jan
authors.initials: J
authors.lastname: Sobesky
authors.forename: Christian Hans
authors.initials: CH
authors.lastname: Nolte
authors.forename: Ian
authors.initials: I
authors.lastname: Wellwood
authors.forename: Peter Ulrich
authors.initials: PU
authors.lastname: Heuschmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001604:Berlin; D002545:Brain Ischemia / Q000150:complications*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D020521:Stroke / Q000150:complications*